A Feeble Response to Ebola

By Silas Kpanan’Ayoung Siakor and Nora Bowier

Sept. 12, 2014

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Health workers in Monrovia, Liberia in August.CreditCreditDaniel Berehulak for The New York Times

MONROVIA, Liberia — The spread of the Ebola virus across West Africa has been fast and deadly. The World Health Organization has characterized the speed and extent of the outbreak as unprecedented. To date, at least 2,288 people in the region have died, and some 4,269 confirmed or probable cases have been reported. But the global response has been underwhelming; the aid group Doctors Without Borders has characterized international efforts to tackle the crisis as “dangerously inadequate.”

Liberia has been hardest hit by the epidemic. So far the country has counted 1,224 likely Ebola deaths, of which 508 have been confirmed by laboratory testing. Most of its hospitals have either closed or are barely functioning. In Bong County, in the north, the two largest hospitals have been shuttered, leaving over 330,000 people without health care. As foreign staff depart, borders close and the last planes leave, it seems that the world intends to cut us off and allow us to die.

Though the risks to the West posed by Ebola are minimal, Western media have fanned irrational fears, fueling panic about the spread of the virus to Europe and North America rather than calling for international assistance to combat the crisis in West Africa. The Western press blames superstition, myths and ignorance for the virus’s spread through the region — not the fact that West African facilities are inadequate and overwhelmed; government finances are already stretched to capacity; there is widespread corruption and poor coordination among government agencies; and the international response has been pitiful.

Liberia, which emerged from its 14-year civil war in 2003, simply does not have the infrastructure to manage the Ebola crisis. It should not be expected to handle the worst outbreak of the world’s deadliest virus on its own. The international community must act now to stop the situation from spiraling further out of control.

Liberia began rebuilding its health system following the end of the war; a reconstruction process that was nowhere near complete when the virus struck. Combating Ebola requires significant medical expertise and manpower, expensive equipment for real-time testing, and treatment centers. Liberia, which lacks enough personnel to transport victims to the facilities that do exist, is far from being able to provide these state-of-the-art resources.

One 120-bed isolation unit, opened in August in Monrovia, the capital, by Doctors Without Borders, reached capacity in its first week. Many families have been forced to care for their loved ones at home, as they are either unable to find ambulances to transport them to treatment centers, or turned away upon arrival due to lack of space. This has only accelerated the spread of the virus. According to Red Cross representatives in Liberia, the crematorium in Monrovia is unable to keep up with the number of dead bodies it receives, and has had to turn away the highly contagious corpses of victims.

The Liberian legislature’s health committee concedes that the government’s Ebola Task Force cannot manage the prevention and treatment of suspected and confirmed cases of the virus, and has stressed the need for international agencies to take over coordination of the Ebola response. Doctors Without Borders, too, has concluded that Liberia’s health system can’t cope. The country urgently needs properly equipped and fully staffed treatment centers in its largest cities and Ebola hotspots.

The W.H.O., in an assessment released this week, found that in Montserrado county, which includes the capital, 1,000 beds are needed to treat infected Ebola patients; only 240 are currently available. There is also an urgent need for medical expertise and human resources, including infectious disease experts and disaster relief specialists, to implement coordinated national and regional responses.

But the problems facing the country go beyond the virus itself: Liberia must now also manage an array of secondary crises that have metastasized in the wake of the Ebola outbreak. As medical facilities close due to fears of contamination, many people have become ill or have died from easily preventable and treatable diseases like malaria and diarrhea. The country imports at least half of its staple consumables; the suspension of many international flights to Liberia has only increased food insecurity. With prices rising and basic provisions dwindling fast, an uptick in refugees trying to escape across borders is inevitable.

The Ebola outbreak is an international crisis and demands an international response before the entire region collapses into chaos. Absent massive international medical aid, Liberia could see tens of thousands of deaths in the coming months. And the spread of the virus to neighboring Ivory Coast, Ghana and other countries in the region could trigger an even larger humanitarian crisis.

How many more families must be wiped out, how many more Liberians must die before world leaders appreciate the severity of the situation, and act?

Silas Kpanan’Ayoung Siakoris the founder of Liberia’s Friends of the Earth/Sustainable Development Institute. Nora Bowier coordinates the Institute’s community awareness and support team.